Mazur Marcel, Czarnobilska Ewa
Department of Clinical and Environmental Allergology, Medical College, Jagiellonian University, Botaniczna St. 3, 31-501 Krakow, Poland.
Int J Mol Sci. 2025 Jun 21;26(13):5966. doi: 10.3390/ijms26135966.
Allergic diseases have been increasing in prevalence over the last years. In a polluted environment, this problem can worsen and become more complex. Long-term exposure to air pollution can lead to the aggravation of allergic rhinitis (AR) and even to the development of seasonal asthma. Climate changes can accelerate and extend the pollination season. Research indicates that air pollution may modify the properties of pollen, making it more aggressive. Asymptomatic allergic people disclose their allergies in a polluted environment. A polluted environment complicates the diagnosis of seasonal allergies. The treatment might be more challenging as standard allergy medications may not be enough to control symptoms. The causal treatment of allergic rhinitis is specific allergen immunotherapy (AIT), which may prove less effective in people living in a polluted environment. The problem may lie in the proper evaluation for AIT as well as the assessment of its effectiveness. To date, the best way to confirm an allergy and qualify a patient for AIT seems to be molecular diagnostics. The question arises whether patients exposed to air pollution, which could potentially reduce the effectiveness of AIT, are still eligible for AIT. It is also debatable whether molecular diagnostics remain effective in such cases. Advancing precision medicine alongside environmental management represents a critical pathway toward reducing the growing global burden of allergic diseases.
在过去几年中，过敏性疾病的患病率一直在上升。在污染的环境中，这个问题会恶化并变得更加复杂。长期暴露于空气污染会导致过敏性鼻炎（AR）加重，甚至引发季节性哮喘。气候变化会加速并延长授粉季节。研究表明，空气污染可能会改变花粉的特性，使其更具侵袭性。无症状的过敏人群在污染环境中会显现出过敏症状。污染的环境使季节性过敏的诊断变得复杂。由于标准的过敏药物可能不足以控制症状，治疗可能更具挑战性。过敏性鼻炎的病因治疗是特异性变应原免疫疗法（AIT），但在生活在污染环境中的人群中，其效果可能较差。问题可能在于对AIT的正确评估及其有效性的评估。迄今为止，确认过敏并使患者符合AIT条件的最佳方法似乎是分子诊断。对于暴露于空气污染中（这可能会降低AIT的有效性）的患者是否仍有资格接受AIT，这一问题也随之而来。在这种情况下，分子诊断是否仍然有效也存在争议。推进精准医学并加强环境管理是减轻全球日益增长的过敏性疾病负担的关键途径。
